The unsolved problem in three-dimensional surgical planning for patients with facial deformity, dysgnathia, or asymmetry is the lack of a normative database of “norm skulls” that can be used as treatment objectives. A study was conducted on 90 Eurasian persons (46 male and 44 female adults) with normal and balanced facial appearance, skeletal Class I pattern, and proper interincisal relationship with normal occlusion. Cone-beam computed tomography was performed. 18 landmarks were digitized and 3D cephalometric measurements of overall facial features, skull, midface and mandible were performed and analyzed by means of proportions calculated from the landmarks. Male and female skulls were analyzed as well as subdivisions revealed by cluster analysis. The data showed that four subtypes of skulls were distinguishable with statistical significance (p< 0,05). A male and a female type subdivided in a brachiocephalic and dolichocephalic phenotype could be identified. For each type then a mean shape was calculated by a Procrustes transformation, which in turn was used to create four template skulls from a male and a female skull by means of a thin plate spline transformation. The normative data of the subtypes can individually serve as a guide for orthodontic surgery, especially helpful in 3D plan-ning and execution of craniofacial operations.

Understanding tumor attachments and management of feeding arteries are very important factors to achieve safe resection of skull base meningioma. We examined the distributions and frequencies of feeding arteries in skull base meningioma by cerebral angiography, and also assessed relationships to tumor attachment for skull base meningioma. We enrolled patients with skull base meningioma who underwent MRI and cerebral digital subtraction angiography (DSA), from September 2015 to October 2022. Subjects comprised 115 patients (32 males, 83 females; mean age, 52.7 years) with 117 meningiomas showing tumor attachments around the “cavernous sinus to upper part of the clivus” (Area 1), “lower part of the clivus to foramen magnum” (Area 2), and “tentorium around the petrous bone” (Area 3). We examined feeding arteries based on cerebral angiography and counted the number of related feeding arteries. Particularly frequent arteries, such as the dorsal meningeal artery (DMA), ascending pharyngeal artery (APA), tentorial artery (TA), and petrosal branch (PB) of the middle meningeal artery (MMA) were analyzed for associations of tumor attachment to Areas 1–3. DMA, APA, TA, and PB are very frequent feeding arteries among skull base meningiomas. In some cases, the artery of the foramen rotundum, posterior ethmoidal artery, recurrent meningeal artery, posterior meningeal artery, etc., supply blood to the skull base meningioma. Meningiomas with DMA as a feeding artery correlated strongly with tumor attachment to Area 1 (p&lt;0.001). Meningiomas with APA correlated strongly with tumor attachment to Area 2 (p&lt;0.001). Meningiomas with TA correlated strongly with tumor attachment to Area 3 (p&lt;0.001). PB correlated with Area 3 (p&lt;0.05). Visualization of these arteries suggests tumor attachments to the correlated areas. An accurate anatomical understanding of tumor attachment and feeding arteries is essential to determine appropriate surgical strategies for skull base meningioma. Pre-operative DSA can provide further understanding of the feeding arteries and attachments of skull base meningioma.

Structure - function interdependence is a universal phenomenon in biological systems. Any alteration in structural features may result in change in functions–leading to natural selection of a particular trait, or dysfunctions thereof. Many such alterations arise during the course of evolution of a species and may meticulously be traced during embryonic development of an organism. Through the theoretical construct of morphological integration, a set of phenotypic traits alter in a coordinated and integrated manner during evolution and embryonic development of an organism yielding efficient environmentally adapted physiological functions pertinent to those structures. Such integration may go awry sometimes, setting the basis for genesis of diseases. Morphological integration in human skull has been established through various methods. The brain-skull co-development is handcuffed through evolution and development, and the very basis of a neuro-psychiatric disorder could be underlying in dysmorphogenesis of the skull, its consequent effect on structures, and thus functions of the pertinent brain components. Here we propose that morphological integration in human skull may be mechanistically implied in etiogenesis of certain neuro-psychiatric disorders and should be borne in mind during clinical diagnosis and therapeutic interventions.

Introduction: We undertook the present study to analyze morphological features of a skull supposed to be that of Alum Bheg, a martyr from 1857 Indian Freedom Struggle (also called Sepoy Mutiny), using established methods to validate identity with regards to age and height as available in the note found with the skull (about 32 year and 5 feet 7½ inch). Methods: Identification of sex of the skull was done based on established criteria. Analysis for closure of skull sutures (cranial and facial) and measurement of orbitomedial (OM) & maxillomedial (MM) facial anthropometric lines were undertaken to provide an estimated age against each examined suture as well as group of sutures through established scoring systems. Further, approximate height of individual was estimated from skull length using regression equations from a reference adult Indian male population. Results: Established criteria confirmed that the skull was of a male individual and skull sutures and age related morphological changes in bones indicate that it belonged to an individual in age range 20 -50 years with an average of 30 years and approximate height between 5 feet 8.2 inch to 6 feet 1 inch. Discussion: Based on our observations we suggest that the skull belonged to a male individual around 30 years of age and height 5 feet 8.2 inch to 6 feet 1 inch. The observed values are in approximation with that mentioned in the historical note and slight differences may be attributed either to gross reporting of original values or limitations of anthropometric analysis.

Surgical ciliated cysts occur primarily in the maxilla after radical maxillary sinus surgery. We report a first case of a surgical ciliated cyst that developed in the infratemporal fossa 25 years after the patient sustained severe facial trauma. The patient complained of mandibular pain and limited mouth opening. The patient’s condition was completely resolved 5 months after marsupialization via Le Fort I osteotomy. Surgical morbidities can be minimized by proper diagnosis and less invasive surgery.

The treatment of large-area bone defects remains a challenge; however, various strategies have been developed to improve the performances of scaffolds in bone tissue engineering. In this study, poly(lactide-co-glycolide)/hydroxyapatite (PLGA/HA) scaffold was coated with Asp-Gly-Glu-Ala (DGEA)-incorporated collagen for the repair of rat skull defect. Our results indicated that the mechanical strength and hydrophilicity of PLGA/HA scaffold were clearly improved and conducive to cell adhesion and proliferation. The collagen-coated scaffold with DGEA significantly promoted the repair of skull defect. These findings indicated that a combination of collagen coating and DGEA improved scaffold properties for bone regeneration, thereby providing a new potential strategy for scaffold design.

In the diagnosis of olfactory neuroblastoma (ONB), the presence of S-100–positive sustentacular cells surrounding the tumor is important; however, these are also present in normal nasal sinus epithelium. Although ONB often has a different final diagnosis, complete resection of the tumor has a good prognosis and minimally affects the patient's treatment plan. When the tumor extends around the internal carotid artery (ICA), complete resection is difficult due to the high risk of vascular injury; revascularization using a high-flow bypass can avoid this complication. In the present case, the tumor was located in the left sphenoid sinus and extended around the ICA. Preoperative biopsy tissue was positive for neuroendocrine markers and slightly positive for S-100 protein, leading to a diagnosis of ectopic ONB. High-flow bypass revascularization with trapping of the ICA allowed complete tumor resection. The postoperative histopathological diagnosis was neuroendocrine carcinoma, showing no S-100 protein–positive cells. There was no sign of recurrence two and a half years after surgery without additional treatment. This case demonstrates that the presence of S-100 protein–positive cells in ONB may be misleading. Although misdiagnosis of ectopic ONB should be anticipated, a complete resection of the tumor is an effective treatment strategy.